In some parts of the world, family planning is still a distant dream
THREE decades ago, many pundits were saying that an ever-rising population could lead to global disaster. They argued that ecological catastrophe, resource wars and other tragedies were inevitable unless radical measures were taken to defuse the coming “population bomb”. Happily, a mixture of technological innovation, economic dynamism and successful population-control strategies have helped defuse that bomb, or at least delay its detonation.
As the United Nations commemorated World Population Day this week, there was reason for cheer. Population experts have been busy revising their long-term scenarios downward to account for falling fertility not only in wealthy Europe and Japan but also in poor countries like Bangladesh and Kenya. Stan Bernstein of the UN Population Fund (UNFPA) even insists that “this is one of the great development success stories of the last 40 to 50 years,” pointing out that the active use of family-planning techniques in developing countries has shot up from 10% to 12% in the early 1960s to over 60% today.
That is impressive, but there is a second, less happy population story. Even as the world in general has been getting a grip on the population problem, things still look bleak for the poorest people in the world. Mona Byrkit of CARE, a charity, calls this the “huge unfinished business” of the population-control movement.
In a report released this week, experts at the World Bank show that 35 countries (31 of them in sub-Saharan Africa) are lagging badly, with sky-high fertility rates and limited access to family-planning tools. In contrast with the relative success that many post-Soviet countries have had in increasing access to contraceptives, the agency’s investigators have shown how African women are too often forced to turn to poorly executed abortion as “contraception of last resort”—sometimes with fatal results (see chart above).
What particularly troubles Sadia Chowdhury, one of the report’s authors, is what the agency calls “unmet need for contraception”: the difference between how many children a woman in, say, an African village wants to have and the number she actually ends up bearing. Even allowing for all cultural and economic factors that might prompt such women to produce more children than their sisters in wealthy countries, there seems to be a huge gap (see chart below).
Why does this happen? Money is not the main reason. In most developing countries, contraception is in theory available to the indigent either free or at nominal cost through state agencies. The trouble is that these bureaucracies are often inefficient, understaffed and incapable of working properly in rural areas.
Politics clearly plays a role. One factor, says CARE’s Ms Byrkit, is the social conservatism of the Bush administration, which makes it hard for those receiving American funding (for HIV/AIDS, for example) even to work with charities providing abortion counselling. Another problem is flagging political momentum. The very success of many parts of the world in limiting population has sapped donors’ enthusiasm. The UNFPA’s Mr Bernstein likens this to the first finishers of a marathon declaring the race over before the rest of the runners cross the finish line.
If bad politics leads to terrible results, the reverse may also hold good. Ms Chowdhury points to the success of her native Bangladesh; she says political will and female empowerment can make all the difference even in a poor country. And there are some other positive signs on the political front. The UN has recently, and not before time, decided that population control should be one of its much-vaunted Millennium Development Goals.
July 10th, 2008, The Economist
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How can contraception be more effectively distributed to poorer developing countries? Changing negative perceptions about condoms and abortion both in the donor and benefiting countries would surely help. No woman should have to end up with more children than she is willing to have. This, even more than the issue of overpopulation, is the most important reason for making sure everyone has access to a family planning center, no matter where they live.
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